Individual
JONATHAN THOMAS SUTTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
722 E UNIVERSITY WAY, ELLENSBURG, WA 98926-2947
(509) 962-1553
(509) 962-1554
Mailing address
PO BOX 2689, WENATCHEE, WA 98807-2689
(509) 260-1051
(888) 538-7694
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00006580
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162229
LABOR & INDUSTRIES
WA
05
—
8344749
—
WA
01
—
98725SU
REGENCE BLUE SHIELD
WA
Enumeration date
03/26/2007
Last updated
05/13/2020
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